血清25-羟维生素D水平与儿童骨密度的相关性研究
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摘要
目的:研究血清25-羟维生素D[25-(OH)D]水平与儿童骨密度(BMD)的相关性。方法:选择2017年1月到2017年12月在亳州市人民医院接受健康体检的儿童100例作为研究对象。根据血清25-(OH)D水平对维生素D(Vit D)营养状况进行分组,其中严重缺乏组9例,缺乏组28例,不足组42例和充足组21例。对比不同年龄段和不同性别儿童血清25-(OH)D、BMD水平以及不同Vit D营养状况儿童对应的BMD水平,并采用Spearman相关性分析法分析血清25-(OH)D水平与儿童BMD、年龄的相关性。结果:5-9岁和10-14岁儿童的血清25-(OH)D及BMD水平均分别低于1-4岁儿童,而10-14岁儿童又低于5-9岁儿童(P<0.05)。男童的血清25-(OH)D及BMD水平均分别高于女童,差异有统计学意义(P<0.05)。不足组、缺乏组、严重缺乏组儿童的BMD水平均分别低于充足组,且缺乏组和严重缺乏组低于不足组,严重缺乏组又低于缺乏组(P<0.05)。根据Spearman相关性分析结果显示,血清25-(OH)D水平与儿童BMD呈正相关,而与年龄呈负相关(P<0.05),年龄与儿童BMD呈负相关(P<0.05)。结论:血清25-(OH)D水平与儿童BMD呈正相关,但与年龄则呈负相关,及时补充适量的Vit D以满足儿童的机体所需,有利于儿童健康成长。
Objective: To study the correlation between serum 25-hydroxyvitamin D [25-(OH)D] level and bone mineral density(BMD) in children. Methods: 100 children who were received physical examination in Bozhou People's Hospital from January 2017 to December 2017 were selected as the research subjects.According to the serum 25-(OH) D level, the nutritional status of vitamin D(Vit D) in children was divide into groups, including severe deficiency group with 9 cases, deficiency group with 28 cases, insufficiency group with 42 cases and sufficient group with 21 cases. The levels of serum 25-(OH)D and BMD in children with different ages and sexes were compared, and the level of BMD in children with different Vit D nutritional status was compared, the correlation between serum 25-(OH)D level and BMD, age of children was analyzed by Spearman correlation analysis. Results: The levels of serum 25-(OH)D and BMD in children aged 5-9 and 10-14 years old were significantly lower than those of children aged 1-4 years old, children aged 10-14 years old was significantly lower than children aged 5-9 years old(P<0.05). The levels of serum 25-(OH)D and BMD in boys were higher than those of girls, and the difference was statistically significant(P<0.05). The level of BMD of children in insufficiency group, deficiency group and severe deficiency were lower than that in sufficient group, respectively, the deficiency group and severe deficiency group was significantly lower than that of insufficiency group, the severe deficiency group was lower than that of the deficiency group(P<0.05). The results of Spearman correlation analysis show that serum 25-(OH)D level was positively correlated with BMD in children, but which was negatively correlated with age(P<0.05), age was negatively correlated with BMD in children(P<0.05). Conclusion: The level of serum25-(OH) D is positively correlated with BMD in children, but it is negatively correlated with age. It is necessary to replenish the right amount of Vit D in time to meet the needs of children's body, which is beneficial to the healthy growth of children.
Objective: To study the correlation between serum 25-hydroxyvitamin D [25-(OH)D] level and bone mineral density(BMD) in children. Methods: 100 children who were received physical examination in Bozhou People's Hospital from January 2017 to December 2017 were selected as the research subjects.According to the serum 25-(OH) D level, the nutritional status of vitamin D(Vit D) in children was divide into groups, including severe deficiency group with 9 cases, deficiency group with 28 cases, insufficiency group with 42 cases and sufficient group with 21 cases. The levels of serum 25-(OH)D and BMD in children with different ages and sexes were compared, and the level of BMD in children with different Vit D nutritional status was compared, the correlation between serum 25-(OH)D level and BMD, age of children was analyzed by Spearman correlation analysis. Results: The levels of serum 25-(OH)D and BMD in children aged 5-9 and 10-14 years old were significantly lower than those of children aged 1-4 years old, children aged 10-14 years old was significantly lower than children aged 5-9 years old(P<0.05). The levels of serum 25-(OH)D and BMD in boys were higher than those of girls, and the difference was statistically significant(P<0.05). The level of BMD of children in insufficiency group, deficiency group and severe deficiency were lower than that in sufficient group, respectively, the deficiency group and severe deficiency group was significantly lower than that of insufficiency group, the severe deficiency group was lower than that of the deficiency group(P<0.05). The results of Spearman correlation analysis show that serum 25-(OH)D level was positively correlated with BMD in children, but which was negatively correlated with age(P<0.05), age was negatively correlated with BMD in children(P<0.05). Conclusion: The level of serum25-(OH) D is positively correlated with BMD in children, but it is negatively correlated with age. It is necessary to replenish the right amount of Vit D in time to meet the needs of children's body, which is beneficial to the healthy growth of children.
引文
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[10]Bao L,Chen M,Lei Y,et al.Association between vitamin D receptor BsmI polymorphism and bone mineral density in pediatric patients:Ameta-analysis and systematic review of observational studies[J]Medicine(Baltimore),2017,96(17):e6718
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[12]Ko觭yi it C,覶atl覦G,nce G,et al.Can Stoss Therapy Be Used in Children with Vitamin D Deficiency or Insufficiency withou Rickets?[J].J Clin Res Pediatr Endocrinol,2017,9(2):150-155
[13]吕成银,谈文峰,张缪佳,等.维生素D与自身免疫病[J].江苏医药2013,39(13):1563-1566
[14]Pekkinen M,Saarnio E,Viljakainen HT,et al.Vitamin D binding protein genotype is associated with serum 25-hydroxyvitamin D and PTH concentrations,as well as bone health in children and adolescents in Finland[J].PLoS One,2014,9(1):87292-89293
[15]Villa CR,Chen J,Wen B,et al.Maternal vitamin D beneficially programs metabolic,gut and bone health of mouse male offspring in an obesogenic environment[J].Int J Obes(Lond),2016,40(12)1875-1883
[16]Rooze S,Mathieu F,Claus W,et al.Effect of calcium and vitamin Don growth,rickets and Kashin-Beck disease in 0-to 5-year-old children in a rural area of central Tibet[J].Trop Med Int Health,2016,21(6):768-775
[17]Rajakumar K,Holick MF,Moore CG,et al.Impact of seasonal flux on 25-hydroxyvitamin D and bone turnover in pre-and early pubertal youth[J].Pediatr Int,2014,56(1):35-42
[18]柴少卿,艾荣,于少飞,等.支气管哮喘患儿血清25羟维生素D3水平对病情评估及临床转归的意义[J].现代生物医学进展,2015,15(34):6721-6724
[19]Hazell TJ,Pham TT,Jean-Philippe S,et al.Vitamin D status is associated with bone mineral density and bone mineral content in preschool-aged children[J].J Clin Densitom,2015,18(1):60-67
[20]Science M,Maguire JL,Russell ML,et al.Prevalence and predictors of low serum 25-hydroxyvitamin D levels in rural Canadian children[J].Paediatr Child Health,2017,22(3):125-129
[21]Acosta-Bendek BM,Sánchez-Majana LP,Fonseca-GaléJ,et al.Serum 25-hydroxyvitamin D state in healthy children ten year minors old of Barranquilla metropolitan area[J].Salud Publica Mex,2017,59(6):657-664
[22]Blakeley CE,Van Rompay MI,Schultz NS,et al.Relationship between muscle strength and dyslipidemia,serum 25(OH)D,and weight status among diverse schoolchildren:a cross-sectional analysis[J].BMC Pediatr,2018,18(1):23
[23]Husmann C,Frank M,Schmidt B,et al.Low 25(OH)-vitamin Dconcentrations are associated with emotional and behavioral problems in German children and adolescents[J].PLoS One,2017,12(8):e0183091
[24]Barja-Fernández S,Aguilera CM,Martínez-Silva I,et al.25-Hydroxyvitamin D levels of children are inversely related to adiposity assessed by body mass index[J].J Physiol Biochem,2018,74(1):111-118
[25]Garcia AH,Erler NS,Jaddoe VWV,et al.25-hydroxyvitamin Dconcentrations during fetal life and bone health in children aged 6years:a population-based prospective cohort study[J].Lancet Diabetes Endocrinol,2017,5(5):367-376
[26]Akkermans MD,Eussen SR,van der Horst-Graat JM,et al.Amicronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children:a randomized,double-blind controlled trial[J].Am J Clin Nutr,2017,105(2):391-399
[27]Roh YE,Kim BR,Choi WB,et al.Vitamin D deficiency in children aged 6 to 12 years:single center's experience in Busan[J].Ann Pediatr Endocrinol Metab,2016,21(3):149-154
[28]Yu X,Zhang J,Yan C,et al.Relationships between serum25-hydroxyvitamin D and quantitative ultrasound bone mineral density in 0-6 year old children[J].Bone,2013,53(1):306-310
[29]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279
[30]Gómez-Campos R,Andruske CL,Arruda M,et al.Proposed equations and reference values for calculating bone health in children and adolescent based on age and sex[J].PLoS One,2017,12(7):e0181918
[2]Kirac D,Dincer Yazan C,Gezmis H,et al.VDBP,VDR Mutations and Other Factors Related With Vitamin D Metabolism May Be Associated With Type 1 Diabetes Mellitus[J].Cell Mol Bio(Noisy-le-grand),2018,64(3):11-16
[3]Zhu Y,Wang PP,Zhai G,et al.Association of rs2282679 A>Cpolymorphism in vitamin D binding protein gene with colorectal cancer risk and survival:effect modification by dietary vitamin Dintake[J].BMC Cancer,2018,8(1):155
[4]Ao T,Kikuta J,Ishii M.Update on recent progress in vitamin Dresearch.The effects of vitamin D in autoinflammatory diseases[J]Clin Calcium,2017,27(11):1551-1559
[5]Li W,Cheng X,Guo L,et al.Association between serum25-hydroxyvitamin D concentration and pulmonary infection in children[J].Medicine(Baltimore),2018,97(1):e9060
[6]Ekiz T,Ye en SF,Katar MK,et al.25-Hydroxyvitamin D levels and bone mineral density evaluation in patients with cholecystectomy:a case-control study[J].Arch Osteoporos,2018,13(1):14
[7]Tamaki J,Iki M,Sato Y,et al.Total 25-hydroxyvitamin D levels predict fracture risk:results from the 15-year follow-up of the Japanese Population-based Osteoporosis(JPOS)Cohort Study[J]Osteoporos Int,2017,28(6):1903-1913
[8]Lee DY,Jee JH,Cho YY,et al.Serum 25-hydroxyvitamin D cutoffs for functional bone measures in postmenopausal osteoporosis[J]Osteoporos Int,2017,28(4):1377-1384
[9]Zhu K,Oddy WH,Holt P,et al.Tracking of vitamin D status from childhood to early adulthood and its association with peak bone mass[J].Am J Clin Nutr,2017,106(1):276-283
[10]Bao L,Chen M,Lei Y,et al.Association between vitamin D receptor BsmI polymorphism and bone mineral density in pediatric patients:Ameta-analysis and systematic review of observational studies[J]Medicine(Baltimore),2017,96(17):e6718
[11]Tseng MH,Huang SM,Lo FS,et al.Functional Analysis of VDRGene Mutation R343H in A Child with Vitamin D-Resistant Rickets with Alopecia[J].Sci Rep,2017,7(1):15337
[12]Ko觭yi it C,覶atl覦G,nce G,et al.Can Stoss Therapy Be Used in Children with Vitamin D Deficiency or Insufficiency withou Rickets?[J].J Clin Res Pediatr Endocrinol,2017,9(2):150-155
[13]吕成银,谈文峰,张缪佳,等.维生素D与自身免疫病[J].江苏医药2013,39(13):1563-1566
[14]Pekkinen M,Saarnio E,Viljakainen HT,et al.Vitamin D binding protein genotype is associated with serum 25-hydroxyvitamin D and PTH concentrations,as well as bone health in children and adolescents in Finland[J].PLoS One,2014,9(1):87292-89293
[15]Villa CR,Chen J,Wen B,et al.Maternal vitamin D beneficially programs metabolic,gut and bone health of mouse male offspring in an obesogenic environment[J].Int J Obes(Lond),2016,40(12)1875-1883
[16]Rooze S,Mathieu F,Claus W,et al.Effect of calcium and vitamin Don growth,rickets and Kashin-Beck disease in 0-to 5-year-old children in a rural area of central Tibet[J].Trop Med Int Health,2016,21(6):768-775
[17]Rajakumar K,Holick MF,Moore CG,et al.Impact of seasonal flux on 25-hydroxyvitamin D and bone turnover in pre-and early pubertal youth[J].Pediatr Int,2014,56(1):35-42
[18]柴少卿,艾荣,于少飞,等.支气管哮喘患儿血清25羟维生素D3水平对病情评估及临床转归的意义[J].现代生物医学进展,2015,15(34):6721-6724
[19]Hazell TJ,Pham TT,Jean-Philippe S,et al.Vitamin D status is associated with bone mineral density and bone mineral content in preschool-aged children[J].J Clin Densitom,2015,18(1):60-67
[20]Science M,Maguire JL,Russell ML,et al.Prevalence and predictors of low serum 25-hydroxyvitamin D levels in rural Canadian children[J].Paediatr Child Health,2017,22(3):125-129
[21]Acosta-Bendek BM,Sánchez-Majana LP,Fonseca-GaléJ,et al.Serum 25-hydroxyvitamin D state in healthy children ten year minors old of Barranquilla metropolitan area[J].Salud Publica Mex,2017,59(6):657-664
[22]Blakeley CE,Van Rompay MI,Schultz NS,et al.Relationship between muscle strength and dyslipidemia,serum 25(OH)D,and weight status among diverse schoolchildren:a cross-sectional analysis[J].BMC Pediatr,2018,18(1):23
[23]Husmann C,Frank M,Schmidt B,et al.Low 25(OH)-vitamin Dconcentrations are associated with emotional and behavioral problems in German children and adolescents[J].PLoS One,2017,12(8):e0183091
[24]Barja-Fernández S,Aguilera CM,Martínez-Silva I,et al.25-Hydroxyvitamin D levels of children are inversely related to adiposity assessed by body mass index[J].J Physiol Biochem,2018,74(1):111-118
[25]Garcia AH,Erler NS,Jaddoe VWV,et al.25-hydroxyvitamin Dconcentrations during fetal life and bone health in children aged 6years:a population-based prospective cohort study[J].Lancet Diabetes Endocrinol,2017,5(5):367-376
[26]Akkermans MD,Eussen SR,van der Horst-Graat JM,et al.Amicronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children:a randomized,double-blind controlled trial[J].Am J Clin Nutr,2017,105(2):391-399
[27]Roh YE,Kim BR,Choi WB,et al.Vitamin D deficiency in children aged 6 to 12 years:single center's experience in Busan[J].Ann Pediatr Endocrinol Metab,2016,21(3):149-154
[28]Yu X,Zhang J,Yan C,et al.Relationships between serum25-hydroxyvitamin D and quantitative ultrasound bone mineral density in 0-6 year old children[J].Bone,2013,53(1):306-310
[29]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279
[30]Gómez-Campos R,Andruske CL,Arruda M,et al.Proposed equations and reference values for calculating bone health in children and adolescent based on age and sex[J].PLoS One,2017,12(7):e0181918